Purpose or Case Report: To review unusual sonographic findings of tumors and tumor-like conditions one can encounter in pediatric scrotal ultrasound and to design a diagnostic algorithm that can be useful with the challenges of differential diagnosis in this situation.
Methods & Materials: Retrospective review of scrotal ultrasound examinations performed in our institution, a tertiary pediatric hospital, between 2000 and 2015. Cases of unusual tumoral pathology or atypical sonographic presentation of common scrotal tumors and tumor-like conditions were selected and grouped according to certain imaging features, which included location of lesion (intra or extratesticular), texture (homogenous or heterogeneous), presence of cystic areas, fat and/or calcifications, and degree of vascularity on Doppler interrogation. Patient information collected included patient’s age. Histopathology report of these tumors was reviewed whenever available.
Results: Categorization of the lesions based on patient’s age and sonographic features allowed creation of a systematic approach to scrotal tumoral conditions that helped in the differential diagnosis.
Conclusions: A systematic approach to unusual tumor and tumor-like conditions found in scrotal ultrasound is our advice to face what they never teach us.